Individual
MR. SRINIVAS MIRYANAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05010247A
IN
225100000X
Physical Therapist
5501015050
MI
Other
Enumeration date
06/02/2010
Last updated
06/02/2010
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